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Troglitazone

Troglitazone (Rezulin®, Resulin® or Romozin®) is a member of the drug class of the thiazolidinediones. It was introduced in the late 1990s but turned out to be associated with an idiosyncratic reaction leading to drug-induced hepatitis. It was withdrawn from the USA market on 21 March 2000, and from other markets soon afterwards. more...

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Troglitazone, like the other thiazolidinediones (pioglitazone and rosiglitazone), works by activating PPARs (peroxisome proliferator-activated receptors). Troglitazone is a ligand to both PPARα and - more strongly - PPARγ. Troglitazone also contains an α-tocopheroyl moiety, potentially giving it vitamin E-like activity in addition to its PPAR activation. It has been shown (Aljada et al) to reduce inflammation: troglitazone use was associated with a decrease of nuclear factor kappa-B (NFκB) and a concomitant increase in its inhibitor (IκB). NFκB is an important cellular transcription regulator for the immune response.

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Troglitazone recommended for second-line combination use
From Nurse Practitioner, 6/1/99

An FDA advisory panel has recommended that troglitazone (Rezulin) be used only as a second-line diabetes therapy in combination with other diabetes drugs (F-D-C Reports. 1999;March 29:14-15). A majority of the panelists voted to recommend that the benefits of troglitazone as monotherapy do not outweigh the risks associated with use of the drug. Panel members further recommended that troglitazone's approved indications be changed so that the drug may only be used in combinations to treat patients who have failed other therapies.

Advisory panel members want comprehensive patient education materials to be given to patients taking troglitazone, hoping that such material will improve compliance with required monthly liver enzyme tests. Furthermore, patient education materials may help alert patients to the signs of liver problems so they can seek early medical attention.

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